Reducing the number of preventable patient injuries in California hospitals from 2001 to 2005 was associated with a corresponding drop in malpractice claims against physicians, according to a new study by the RAND Corporation.
"Is Better Patient Safety Associated with Less Malpractice Activity? Evidence from California" examined both medical malpractice claims and adverse events such as post-surgical infections in California and found that changes in the frequency of adverse events were strongly correlated with corresponding changes in the volume of medical malpractice claims.
"These findings suggest that putting a greater focus on improving safety performance in healthcare settings could benefit medical providers as well as patients," said Michael Greenberg, the study's lead author and a behavioral scientist with RAND, a nonprofit research organization.
Greenberg said the RAND study is the first to demonstrate a link between improving performance on 20 well-established indicators of medical safety outcomes and lower medical malpractice claims.
The RAND team analyzed information for approximately 365,000 adverse safety events, such as post-surgical problems and hospital-acquired infections, and for approximately 27,000 malpractice claims, all of which occurred during 2001-2005. The researchers found considerable variation among California's counties in the frequency of adverse events and malpractice claims.
The study also found a significant connection between the annual frequency of adverse events in each county and the number of malpractice claims made. For example, under the model created by researchers, a county that experienced 10 fewer safety events in a given year would also expect to see a reduction of 3.7 malpractice claims during the same year, said study co-author Amelia Haviland, a RAND statistician.
"The patient safety movement suggests that patient injuries sometimes occur as a result of the failure of complex systems rather than negligence, and that efforts to identify the root causes of these failures are an important tool for protecting patients and for reducing injury rates," Greenberg said.
Evidence that safety performance has a direct link to malpractice claims suggests that policy interventions designed to boost safety also might have the effect of improving the malpractice litigation climate, Greenberg said.
The study was produced under the auspices of the RAND Institute for Civil Justice and funded by pooled contributions from insurance companies, individuals and nonprofit groups.